001ABA64.001

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     7      INTEGRATED PLANNING ACT 1997                                                                                    Part A, Version 3.1, 3 March 2008
             7 ‘eel    er   a                                                                  A
                                    Form 1 Development Application.                                        ~~.                         idas
                7                                                   Part                 A
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            \                                                  Common details
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             NOTE: Answer all questions unless directed to go to a particular question. Refer to the end of the form for advice on how to complete this form.
            ‘Applicant detallS: (he Appicant i he person responsibe for making tte applicalion and Reed not be the ounerof fe and, The AppICaTT mS /eaponsible for ONSUFTG Te |
            {information provided oh the-1DAS Application Form is correct. This information is Felied.upan by the Assessment Mariager and any referral.agencles when assessing and 4
            decidiig this applidation,” By lodging this application, the Applicant incurs the obligations and résponsibiities prescribed by the IPA Any development permit or preliminary’ i
            approval that may be issited as a conSequerice of this application will be issued fo the Applicant) ESAS sei’. Gita Sihik aN eta

             Individual applicant/Contact person {if there is more than one applicant, provide additional applicant details on an attachment to this form)
              Title                        First name                                            Lastname       [OFFERMANN
                Postal address               C/- 2INDUSTRIAL AVE, CALOUNDRA           QLD 4551
                Contact telephone number     [07 5492 5925                         Mobile phone number          [fr                         ssiszY
                Facsimile number             07 5492 6699                          e-mail address              [

            Details of the premises (fe. the and on which the develooments proposed velar ine odeeatmeendolmelom i in         nik               tat
             1.  Identify the premises by completing Table A, or Table B and/or Table C (ensure adequate information is given to identify the premises)
             Table A  If the application is for a mobile and temporary Environmentally Relevant Activity (ERA), complete Table A only. Then go to Q2.
            [TREE                            seo na eve                  eee    we      a oie a      enporay ERA      ope oreo
                     A
             OR
             Table B  Street address for the premises (fick applicable box/es below and insert property description in the table. Identify each lot in a separate row.)
       @           (i)  (_] Street address / lot on plan for the premises (Appropriate for most applications including building applications); or
                   (ii) [X] Street address /lot on plan for the land adjoining or adjacent to the premises (Appropriate for development in water e.9. jetty
                            pontoon etc) (Note: Loton plan details may be obtained from title documents, a ‘Rate’ notice, or from the local govemment.)
                             On ae ae                                                         eon           eae peeeeag tae
                             Unit, | Street ier oe    AE ep nan of                  Pee                             HE, dios     .caims   sgl oe
                             hee | Ne    E Sibel nome and ofl ibrar                 sears pine | Plan Number; MA            a ANT Sn       neta
                    [1 |         fos | HILTON TCE, NOOSAVILLE                       }4566 [6        | sP116708_|    SUNSHINE COAST REGIONAL COUNCIL
             AND/OR
             Table C   Coordinates and/or a map of the premises (Appropriate for development in remote areas, over part of a lot, in water (e.g. channel dredging in Moreton
                       Bay} etc.)
                             tas Nate: fe isl icf onotl Fear By er ee                         ae | 2 g.batin                 ig ai eeecnes
                               oe ee cna a                                                 ee            er                  ees
                               go Cam: © Nething            eee cag [ie eeu Reference: Be                   AS    emuudeas ey tse (if epplicableje sie
                             Pe de                                                         a ee a
                             Past:      ced [ieee      cage a ek       hae Nite L      PHP aaa te, agen | Bae go ue     Mt           ee        a
                                                                                                       [J pepags
                                                                                                       LI wese4
                                                                                                       [_] Other -

.            2. _ Identify if any of the following apply to the premises by completing Tables D, E, or F. (Note: in most instances, the premises will not involve any of
                  the following characteristics, however some applications may involve one or more of these characteristics - complete only if applicable)